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目的探讨再次肝切除术在结直肠癌肝转移复发治疗中的应用价值。方法回顾性分析43例结直肠癌肝转移复发再次肝切除术和67例结直肠癌肝转移复发内科化疗的临床资料。结果结直肠癌肝转移复发再手术组和化疗组1,3,5年生存率分别为83.7%,51.1%,27.9%和65.7%,20.6%,3.0%(P<0.05或P<0.01)。再次肝切除组无手术死亡病例,并发症发生率为32.6%。单因素分析显示肝脏复发转移灶个数,切缘情况,CEA,肿瘤大小,肿瘤分化程度与预后有关。多因素回归分析结果表明,仅有肝脏复发转移灶个数和肿瘤大小为影响预后的独立因素。结论再次肝切除术对于结直肠癌肝转移复发是安全的治疗方案,肿瘤负荷较小(癌直径<5 cm和转移灶<3个)的患者预后较好;再次手术可以延长结直肠癌肝转移复发患者的生存时间。
Objective To investigate the value of re-hepatectomy in the treatment of liver metastasis and recurrence of colorectal cancer. Methods Retrospective analysis of 43 cases of colorectal cancer recurrence of liver metastases resection and liver resection recurrence in 67 cases of clinical data of chemotherapy. Results The 1, 3, 5-year survival rates of re-operation group and chemotherapy group were 83.7%, 51.1%, 27.9% and 65.7%, 20.6% and 3.0% respectively (P <0.05 or P <0.01). There was no surgical death in the resection group, with a complication rate of 32.6%. Univariate analysis showed that the number of liver recurrence and metastasis, margins, CEA, tumor size, tumor differentiation and prognosis. Multivariate regression analysis showed that only the number of liver recurrence metastases and tumor size were independent prognostic factors. Conclusions Resection of hepatectomy is a safe treatment for liver metastasis and recurrence of colorectal cancer. Patients with small tumor burden (<5 cm in diameter and <3 metastases) have a better prognosis. Reoperation can prolong liver metastasis of colorectal cancer Recurrence patients’ survival time.